Cardio-Oncology: the intersection of pathologies that mobilizes to current science
Cancer and cardiovascular diseases not only have in common being two diseases most prevalent in the country. They also share some risk factors, and in recent years has shown that cancer treatments generate cardiotoxicity, and that in turn, patients with cardiovascular disease are more prone to develop certain cancer types. In this scenario the Center for advanced studies of chronic diseases (ACCDiS ), put hands to work, rising today as a pioneer in basic research, clinical and epidemiological, about this relationship.
In the coming weeks, the Dr. Sergio Lavandero, Professor Titular of the University of Chile and Director of ACCDiS, published an editorial in the magazine Circulation, one of the most important in the cardiovascular field in the world. The theme? Collusion between cardiovascular diseases and cancer, field on which these days ACCDiS has ventured in new way in the country.
Cancer and cardiovascular disease are the two diseases most prevalent in Chile, both mortality and morbidity. Both share risk factors such as age, unhealthy lifestyles and smoking, and evidence that has risen during the last decade much of medications used successfully for the treatment of cancer, they impact negatively on the cardiovascular system of the patients who receive them.
“At ACCDiS we carry out basic research, clinical and epidemiological cancer and cardiovascular diseases. We have two lines of research which could apparently be understood as separate, But having some bonding, and there is that we went into the theme of onco-Cardiology or cardio-Oncology”, said the Professor of the faculties of chemical and pharmaceutical sciences and medicine of the Casa de Bello.
Two events led to ACCDiS, Center that unites the work of academics and researchers from the University of Chile and the Pontificia Catholic University of Chile, to focus their efforts in this matter. On the one hand, was own Dr. Lavandero, who as an adjunct professor of the University of Texas Southwestern Medical Center in Dallas, He noted how beyond one group of cardiologists – one of the world's leading- He began to develop this area and seek to specialize them in this new discipline. On the other hand, the work in Chile of the Dr. Fernando Florenzano, the Faculty of Medicine of our campus academic, It gave pioneering steps in that direction in recent years, alerting the reality experienced by patients undergoing various treatments against cancer in our country.
So it was as, Explains Professor Lavandero, in ACCDiS it was decided to take this issue and address it in two ways: “The first, perform basic research, test cancer drugs on the heart, and try to study their mechanisms of damage. On the other hand, with the Dres. Pablo Castro and Gonzalo Martinez, We begin to see the clinical aspects. In fact, the PUC in the clinic San Carlos de Apoquindo created the first unit clinic to assist the sick in trying to mitigate the damage caused by antineoplastic therapy or irradiation on the heart”, the academic explained.
That was the initial focus on the issue in the ACCDiS, However the ways of confronting it go beyond, because in this matter “also the reverse situation occurs”, as explained by the director of the Center. “Today we have been realizing in the world, initially through epidemiological studies, to those people who have some cardiovascular problems such as high blood pressure, arrhythmias, heart failure and myocardial infarction, they might be more prone to develop certain types of cancer. Here we see the upside down effect, How could the cardiovascular system influence the development of cancer, and that is a very new area we also studied with the Dres. Andrew Quest and Alejandra Sandoval and the student of our doctoral program in biotechnology Samuel Martinez”, Lavandero said.
First steps in Chile
As noted the Professor Lavandero, It was the cardiologist Fernando Florenzano, Academic Director of the headquarters East of the Faculty of Medicine of the University of Chile, one of the pioneers in our country to the link between the cancer treatments and cardiovascular harms.
“A problem that has been several years ago is that the anticancer drugs, as the chemotherapy, they are quite useful to stop the advance of cancer, and that is one of the main reasons why survival has improved. However, some of these chemotherapy drugs are toxic to the heart. Then, they are drugs which although very well counteract the progression of tumors, Sometimes they can cause heart disease”, said the specialist.
About 5 percent of people who receive antracyclinic in progressive dose, you have any evidence of heart damage although it is very early. “It is not very often, but it has its incidence and, sometimes, patients have been free of cancer, but they are beginning to have a new disease, different, It can also be deadly. That was what did change the look at drugs that have potentially low toxicities”, said Dr. Florenzano.
Next to the antracyclinic, It was then observed that newer generation drugs, as biological therapies and other, they could also generate a small proportion cardiac toxicity, then, said Florenzano “He began to see that this is a more widespread problem, It might not be as frequent individually, but in sum, as there are so many patients that suffer from cancer and many people surviving times longer, you start to notice the cardiotoxicity”.
Text: Francisca Siebert